Brain stem gliomas, clinico radiological study: a classification system with "prognostic significance" is suggested

ABSTRACT

In the present study 21 patients with the clinico-radiological diagnosis of brain stem glioma are included [13 males and 8 females]. Patients were subjected to [1] Full clinical examination [2] MRI and/or CT scan of the brain with and without intravenous contrast enhancement. CT myelography was also done to patients presented with cervicomedullary gliomas. According to the duration of symptomatology before clinical presentation, the anatomical localization of the brain stem gliomas [diffuse versus focal, Cystic versus sold], the pattern of contrast enhancement [non, diffuse, ring or patchy enhancement], the pattern of response to radiotherapy and the overall prognosis during a one year follow up, patients were classified into five groups. Group [1] patients with diffuse brain stem gliomas and with a relatively better prognosis [10 patients, 47.5%], group [2] patients with diffuse brain stem gliomas and with a relatively worse prognosis [4 patients, 19%], group [3] patients with focal pontine or midbrain gliomas [4 patients, 19%], group [4] patients with cervicomedullary gliomas [2 patients, 9.5%] and group [5] a single patient [5%] with probable brain stem metastasis. The clinical and radiological findings in the various groups will presented and discussed. Lines of treatment, clone to each group, and the result of a one year follow up will also be presented and discussed